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Functional analysis of eve stripe 2 enhancer evolution in Drosophila: rules governing conservation and change.

Experimental investigations of eukaryotic enhancers suggest that multiple binding sites and trans-acting regulatory factors are often required for wild-type enhancer function. Genetic analysis of the stripe 2 enhancer of even-skipped (eve), an important developmental gene in Drosophila, provides support for this view. Given the importance of even-skipped expression in early Drosophila development, it might be predicted that many structural features of the stripe 2 enhancer will be evolutionarily conserved, including the DNA sequences of protein binding sites and the spacing between them. To test this hypothesis, we compared sequences of the stripe 2 enhancer between four species of Drosophila: D. melanogaster, D. yakuba, D. erecta and D. pseudoobscura. Our analysis revealed a large number of nucleotide substitutions in regulatory protein binding sites for bicoid, hunchback, Kruppel and giant, as well as a systematic change in the size of the enhancer. Some of the binding sites in D. melanogaster are either absent or modified in other species. One functionally important bicoid-binding site in D. melanogaster appears to be recently evolved. We, therefore, investigated possible functional consequences of sequence differences among these stripe 2 enhancers by P-element-mediated transformation. This analysis revealed that the eve stripe 2 enhancer from each of the four species drove reporter gene expression at the identical time and location in D. melanogaster embryos. Double staining of native eve protein and transgene mRNA in early embryos showed that the reporter gene mimicked native eve expression and, in every case, produced sharply defined stripes at the blastoderm stage that were coincident with eve stripe 2 protein. We argue that stripe 2 eve expression in Drosophila evolution can be viewed as being under constant stabilizing selection with respect to the location of the anterior and posterior borders of the stripe. We further hypothesize that the stripe 2 enhancer is functionally robust, so that its evolution may be governed by the fixation of both slightly deleterious and adaptive mutations in regulatory protein binding sites as well as in the spacing between binding sites. This view allows for a slow but continual turnover of functionally important changes in the stripe 2 enhancer.

Animals↗

The activation and maintenance of Pax2 expression at the mid-hindbrain boundary is controlled by separate enhancers.

Pax2 is the earliest known gene to be expressed throughout the mid-hindbrain region in late gastrula embryos of the mouse and is essential for the formation of an organizing center at the midbrain-hindbrain boundary (MHB), which controls midbrain and cerebellum development. We have used transgenic analysis to identify three MHB-specific enhancers in the upstream region of the mouse Pax2 gene. A 120 bp enhancer (at -3.7 kb) in cooperation with the endogenous promoter was sufficient to induce transgene expression in the anterior neural plate of late gastrula embryos, while it was already inactivated again at the MHB during somitogenesis. The activity of this early enhancer was severely reduced by mutation of three homeodomain-binding sites, two of which are part of a recognition sequence for POU homeodomain proteins. Oct3/4 (Pou5f1), the mouse ortholog of zebrafish Pou2, efficiently bound to this sequence, suggesting its involvement in the regulation of the early Pax2 enhancer. Starting at the four-somite stage, Pax2 is expressed at the MHB under the control of two enhancers located at -4.1 kb and -2.8 kb. The distal late enhancer contains a 102 bp sequence that is not only highly conserved between the mouse and pufferfish Pax2 genes, but also contributes to the enhancer activity of both genes in transgenic mice. The proximal 410 bp enhancer, which overlaps with a kidney-specific regulatory element, contains a functional Pax2/5/8-binding site and thus maintains Pax2 expression at the MHB under auto- and cross-regulatory control by Pax2/5/8 proteins. Importantly, the early and proximal late enhancers are not only sufficient but also necessary for expression at the MHB in the genomic context of the Pax2 locus, as their specific deletion interfered with correct temporal expression of a large Pax2 BAC transgene. Hence, separate enhancers under the control of distinct transcription factors activate and maintain Pax2 expression at the MHB.

5' Flanking Region↗

Contrast-enhanced sonography for differential diagnosis of pleurisy and focal pleural lesions of unknown cause.

BACKGROUND: Ultrasound enables the visualization of pleural-based lesions with a poor correlation to specific pathology. At this time, there are no data about the diagnostic value of contrast-enhanced sonography (CES) in pleural lesions. METHODS: From August 2004 to January 2005, 25 consecutive patients with clinical symptoms of pleurisy and focal pleural lesions of unknown origin seen on B-mode ultrasonography were prospectively studied by CES. The lesions were diagnosed as pleuropneumonia (n = 12), pulmonary embolism/infarction (n = 7), malignant lymphoma (n = 2), pleural metastasis (n = 2), granuloma (n = 1), and unknown cause (n = 1). The diagnosis of the lesions was confirmed by contrast-enhanced CT scanning (n = 20), scintigraphy (n = 3), and follow-up (n = 2). Time to the enhancement of the contrast agent was determined. The CES patterns were evaluated during the arterial phase (ie, 2 to 30 s) and the parenchymal phase (ie, 1 to 5 min). The extent of the enhancement of pleural lesions was classified using normal liver tissue as an in vivo reference (absent, hypoechoic, isoechoic, hyperrechoic, or mixed echogenicity). RESULTS: In 20 patients, an enhancement of the pleural lesion was seen. All 12 patients with pleuropneumonia had a short time to enhancement (between 1 and 6 s), and a marked enhancement (isoechoic/hyperechoic) during the arterial and parenchymal phase. In the remaining 13 patients with other diagnoses than pleuropneumonia, 5 patients had no enhancement and 8 patients had a delayed time to enhancement (> 6 s). The extent of the enhancement was reduced (hypoechoic/anechoic) in 12 of 13 patients during the arterial and parenchymal phases. CONCLUSION: In patients with pleurisy and pleural lesions of unknown cause that were found sonographically, CES enables the diagnosis or exclusion of pleuropneumonia.

Adult↗

Enhancer choice in cis and in trans in Drosophila melanogaster: role of the promoter.

Eukaryotic enhancers act over very long distances, yet still show remarkable specificity for their own promoter. To better understand mechanisms underlying this enhancer-promoter specificity, we used transvection to analyze enhancer choice between two promoters, one located in cis to the enhancer and the other in trans to the enhancer, at the yellow gene of Drosophila melanogaster. Previously, we demonstrated that enhancers at yellow prefer to act on the cis-linked promoter, but that mutation of core promoter elements in the cis-linked promoter releases enhancers to act in trans. Here, we address the mechanism by which these elements affect enhancer choice. We consider and explicitly test three models that are based on promoter competency, promoter pairing, and promoter identity. Through targeted gene replacement of the endogenous yellow gene, we show that competency of the cis-linked promoter is a key parameter in the cis-trans choice of an enhancer. In fact, complete replacement of the yellow promoter with both TATA-containing and TATA-less heterologous promoters maintains enhancer action in cis.

Animals↗

Rheumatoid arthritis of the knee: value of gadopentetate dimeglumine-enhanced MR imaging.

In an attempt to differentiate among joint effusion, synovitis, pannus, and subchondral sclerosis in patients with clinically proved chronic rheumatoid arthritis, we used gadopentetate dimeglumine-enhanced MR imaging to examine 23 patients with acute knee symptoms. All patients had had rheumatoid arthritis for more than 6 months and satisfied four or more of the criteria of the American Rheumatism Association for rheumatoid arthritis. MR imaging was performed on a 1.5-T machine by using unenhanced T1-weighted spin-echo imaging, unenhanced T2*-weighted gradient-echo imaging, and unenhanced and enhanced T1-weighted gradient-echo imaging. Signal intensities of the synovium and bone marrow were measured with the region-of-interest technique on unenhanced and enhanced T1-weighted gradient-echo scans. Conventional radiographs were available for each patient. Joint effusion, synovitis, intraarticular pannus, subchondral sclerosis, and subchondral pannus had the same signal intensities on unenhanced T1-weighted spin-echo, unenhanced T1-weighted gradient-echo, and unenhanced T2*-weighted gradient-echo MR images, and could not be differentiated from one another. On enhanced T1-weighted gradient-echo sequences, pannus and synovitis showed marked enhancement in 15 patients, whereas joint effusion and sclerosis did not. Synovitis was diagnosed if the synovial membrane showed high enhancement; pannus was diagnosed if enhancing masses were seen within the joint space or in the subchondral area. In eight of the 23 joints, there was no enhancement of the synovium or intraarticular or subchondral tissue. We conclude that gadopentetate dimeglumine-enhanced MR imaging allows differentiation between synovitis and joint effusion and between subchondral pannus and subchondral sclerosis. Enhancement of the synovium and pannus indicates acute inflammation of the joint.

Adolescent↗

CT arterial portography of the abdomen: effect of injecting papaverine into the mesenteric artery on hepatic contrast enhancement.

OBJECTIVE: The purpose of this study was to determine the effect of precontrast injection of papaverine hydrochloride into the superior mesenteric artery on the degree of contrast enhancement of the hepatic parenchyma during CT arterial portography (CTAP, CT with injection of contrast material into the superior mesenteric artery). SUBJECTS AND METHODS: Twenty-two patients were included in this study. All patients had a baseline unenhanced CT scan and then had CTAP performed with transcatheter injection of 150 ml of nonionic iodinated contrast material (30 g iodine/100 ml) at a rate of 2 ml/sec. Eleven patients received a precontrast injection of 40 mg of papaverine hydrochloride via catheter into the superior mesenteric artery, and 11 patients had CTAP without papaverine hydrochloride. Attenuation of the liver was measured before and after contrast administration in both groups of patients. For each CTAP section, the absolute hepatic enhancement (postcontrast attenuation--precontrast attenuation) and the relative hepatic enhancement ([absolute hepatic enhancement/precontrast attenuation] x 100) were calculated. Also, the mean absolute enhancement and the mean relative enhancement for the entire liver were calculated for each patient. RESULTS: The mean relative enhancement (+/- SD) of hepatic parenchyma was 192 +/- 54% with papaverine hydrochloride and 146 +/- 26% without papaverine hydrochloride. Relative enhancement was significantly higher when papaverine hydrochloride was used (p < .02). The mean absolute enhancement (+/- SD) of hepatic parenchyma was 123 +/- 25 H with papaverine hydrochloride and 91 +/- 19 H without papaverine hydrochloride. Absolute enhancement was significantly higher in patients who had papaverine hydrochloride (p < .01). CONCLUSION: The results show that precontrast transcatheter infusion of papaverine hydrochloride increases the degree of contrast enhancement of the liver during CTAP.

Aged↗

MR imaging of the normal meninges: comparison of contrast-enhancement patterns on 3D gradient-echo and spin-echo images.

OBJECTIVE: The purpose of this study was to determine the enhancement pattern of the normal meninges on T1-weighted three-dimensional Fourier transform gradient-echo (3DGE) MR images and to compare this pattern with that observed on conventional two-dimensional Fourier transform spin-echo (2DSE) images. This will serve as a basis for comparison when cases of suspected meningeal pathology are evaluated. SUBJECTS AND METHODS: The appearance of the normal meninges after administration of gadopentetate dimeglumine was evaluated on 2DSE and 3DGE images in 69 patients who had no known or suspected meningeal abnormality. The total percentage of meningeal surface area that underwent contrast enhancement and the continuity of meningeal enhancement were evaluated at four anatomic levels. RESULTS: In most patients, 2DSE images showed short segments (i.e., < 3 cm) of meningeal enhancement, with enhancement of less than 50% of total meningeal surface area. However, enhancement of 76-100% of total meningeal surface area was routinely observed on 3DGE images, with long segments (i.e., > 3 cm) or continuous patterns most frequently observed. The differences between 2DSE and 3DGE sequences were statistically significant for all regions that were assessed. CONCLUSION: Continuous meningeal enhancement or enhancement of long segments of normal meninges is routinely observed on contrast-enhanced 3DGE images; this appearance differs from those of enhanced 2DSE images and should not be interpreted as abnormal.

Adult↗

Helical CT of the liver: clinical application of an automated computer technique, SmartPrep, for obtaining images with optimal contrast enhancement.

OBJECTIVES: The purpose of this study was to evaluate an automated computer technique (SmartPrep) for achieving a consistently high level of contrast enhancement in the liver with helical CT. The technique compensates for variability between patients by indicating graphically the time at which scanning should be initiated to reach a desired level of hepatic enhancement. MATERIALS AND METHODS: One hundred nine consecutive patients undergoing helical CT of the abdomen were randomly evaluated, using either a standard 70-sec delay from the start of the injection of contrast material to scanning or a newly developed, commercially available automated technique, SmartPrep. A series of multiple low-dose scans was performed until an arbitrary threshold of hepatic enhancement (50 H) over baseline was achieved. Three regions of interest (ROIs) were imaged on a baseline scan and on contrast-enhanced scans at the upper, mid, and lower liver. Average hepatic enhancement and the standard deviation over baseline was calculated for each group at all anatomic levels. For the SmartPrep group, the range of time between scan initiation and onset of scanning was calculated. RESULTS: The mean hepatic enhancement for the control group (n = 56) was 59.8 +/- 20.1 H, which differed significantly (p = .0002) from that for the SmartPrep group (n = 53), which was 71.6 +/- 15.2 H. Comparison of the variability between the two groups' enhancement levels was also significant (p = .02). The range of delay times for the SmartPrep group was 48-86 sec. In two additional cases, abnormal graphically displayed enhancement curves were the first indication of an improper injection. CONCLUSION: Use of SmartPrep yields a greater and more consistent level of hepatic enhancement from patient to patient than does use of a conventional fixed delay time. The ability to scan more efficiently to achieve greater hepatic enhancement using SmartPrep has significant implications for potential contrast cost savings.

Diagnosis, Computer-Assisted↗

Cirrhotic liver enhancement on dual-phase helical CT: comparison with noncirrhotic livers in 146 patients.

OBJECTIVE: The purpose of this study was to prospectively determine any differences in vascular and liver enhancement between patients with cirrhosis and patients without cirrhosis during both the arterial and portal venous phases on dual-phase helical CT. SUBJECTS AND METHODS: Fifty-eight patients with histologically proven cirrhosis (group 1) and 88 without cirrhosis (group 2 = normal findings on CT, group 3 = metastases, group 4 = other liver diseases) underwent dual-phase helical CT of the liver. Attenuation values of liver and vessels were measured on unenhanced scans and on scans obtained during the arterial and portal venous phases. The mean enhancement values per time interval (5 sec) were determined. Results were analyzed taking into account various intrinsic patient parameters. RESULTS: We found no statistically significant difference in terms of mean vascular enhancement and mean liver enhancement during the arterial imaging phase for each time interval among all the groups. The mean peak enhancement and mean liver enhancement during the portal venous phase were significantly lower in group 1 than in other groups. Time to peak enhancement was significantly delayed in group 1. CONCLUSION: In spite of the hepatic arterial buffer response, mean liver enhancement during the arterial phase was not significantly different in patients with cirrhosis compared with patients without cirrhosis. Although portal vein enhancement did not differ significantly, enhancement of cirrhotic liver was significantly lower during the portal venous phase and delayed, presumably because of decreased peripheral portal perfusion. The contrast injection protocol may be tailored to optimize conspicuity of hypovascular tumor.

Adult↗

Contrast-enhanced carotid MR angiography with commercially available triggering mechanisms and elliptic centric phase encoding.

OBJECTIVE: The technical feasibility of contrast-enhanced MR angiography of the carotid arteries was evaluated with routinely available timing sequences and elliptic centric acquisition. The image quality of the contrast-enhanced MR angiography was compared with that of multiple overlapping thin-section acquisition MR angiography (MOTSA MR angiography). SUBJECTS AND METHODS: Sixty-three patients were enrolled. A 2-mL test bolus and commercially available software were used to time the gadolinium bolus. High-resolution contrast-enhanced MR angiography was performed with elliptic centric acquisition. RESULTS: The average time of bolus arrival was 17.3 sec (range, 12-25 sec). In 60 of the 63 patients, we had excellent or good visualization of the carotid bifurcation using contrast-enhanced MR angiography with little or no venous contamination. Two observers ranked delineation of stenosis and morphology of proximal internal carotid artery and overall diagnostic confidence statistically significantly higher for contrast-enhanced MR angiography compared with MOTSA: Ulceration, length of stenosis, and slow flow distal to a critical stenosis were better depicted with contrast-enhanced MR angiography than with MOTSA: Venetian blind artifact, saturation of slow or in-plane flow, and artifactual narrowing in carotid artery kinks plagued MOTSA but were not seen on contrast-enhanced MR angiography. MOTSA was graded superior to contrast-enhanced MR angiography in nine of 120 carotid bifurcations analyzed. CONCLUSION: High-resolution carotid contrast-enhanced MR angiography is technically feasible. We found a 95% success rate using commercially available hardware and software. The image quality with carotid contrast-enhanced MR angiography has improved so that it is equal or superior to the longer MOTSA in most patients.

Adult↗

Age-related vascular changes in the epiphysis, physis, and metaphysis: normal findings on gadolinium-enhanced MRI of piglets.

OBJECTIVE: We sought to study the normal enhancement patterns seen on MRIs of the epiphysis, physis, and metaphysis and age-related vascular changes in piglets using gadoteridol, a nonionic gadolinium chelate. MATERIALS AND METHODS: We quantitatively and qualitatively analyzed the normal changes on sequential T1-weighted images after the IV administration of gadoteridol. In an investigation approved by the research animal care committee at our hospital, we studied the proximal and distal femurs of 26 piglets 1-6 weeks old and correlated the enhanced images with findings on intermediate-weighted, T2-weighted, and gradient-recalled echo images and at histologic examination. RESULTS: We observed early enhancement of the epiphyseal vascular canals, the main physis, the physis of the secondary ossification center, and a metaphyseal band adjacent to the physis. Enhancement of the epiphyseal and metaphyseal marrow and of the epiphyseal cartilage was slower. In the epiphyseal cartilage, we saw three phases of enhancement: vascular, canalicular, and cartilaginous. As the piglets matured, enhancement of the epiphyseal cartilage decreased, and the epiphyseal vascular canals were less conspicuous. Physeal enhancement was greatest during the first week of life, declined at 3 weeks, and subsequently increased again as the physis came to lie adjacent to a larger segment of the epiphyseal ossification center. CONCLUSION: Gadoteridol-enhanced MRIs showed multiple cartilaginous and vascular structures of the growing skeleton. With maturity and progressive epiphyseal ossification, epiphyseal cartilage enhancement decreased, and physeal cartilage enhancement increased.

Aging↗

Gadolinium-enhanced phase-contrast magnetic resonance portography.

PURPOSE: The purpose of this study was to investigate the effect and usefulness of gadolinium-chelated contrast medium in phase-contrast magnetic resonance (MR) portography. METHODS: Twenty-six patients (21 men, 5 women; aged 34 to 79 years, mean 62 years) underwent respiratory-triggered 3-dimensional phase-contrast portography before and after administration of gadolinium in a 1.5T MR unit. Coronal maximum intensity projection (MIP) images of the portal vein were reconstructed and compared to conventional arterial portograms regarding visualization. Signal-to-noise ratio (SNR) and portal vein-to-liver contrast-to-noise ratios (CNR) of main, right, right anterior, right posterior, left portal veins, and umbilical portion were measured on both non-enhanced and gadolinium-enhanced images and compared. RESULTS: Portal veins and branches were more clearly visualized on the gadolinium-enhanced than on the non-enhanced images. Compared to arterial portography, gadolinium-enhanced portography showed similar performances in visualization, except in the right posterior branch and left portal vein. No severe image degradation from respiration was experienced. SNR was significantly higher on the gadolinium-enhanced than on non-enhanced images except in the right anterior branch. CNR was significantly higher on the gadolinium-enhanced than on the non-enhanced images at all measured locations. CONCLUSIONS: Administration of gadolinium improves the SNR and CNR of phase-contrast portography and visualization of the portal vein. The phase-contrast technique with gadolinium enhancement can be used to evaluate the portal vein as a supplemental technique.

Adult↗

Time-intensity-based quantification of vascularity with single-level dynamic contrast-enhanced ultrasonography: a pilot animal study.

OBJECTIVE: The purpose of this study was to delineate the hemodynamic features of VX2 tumor and perineoplastic liver parenchyma and to evaluate the potential usefulness of single-level dynamic ultrasonography in the diagnosis of tumors by the analysis of time-intensity curves. METHODS: An in vivo animal model was studied using a low mechanical index in conjunction with single-level dynamic contrast-enhanced ultrasonography. A sulfur hexafluoride contrast agent (SonoVue; Bracco SpA, Milan, Italy) was applied in 8 rabbits by intravenous bolus injection. Data were acquired before and after VX2 tumor induction. Corresponding parameters of the time-intensity curve were measured using wash-in/wash-out curve software. RESULTS: No significant difference was found in the time to enhancement, time to peak intensity, peak signal intensity, and enhancement duration between liver parenchyma before and after VX2 tumor induction (P > .05). The typical enhancement pattern of VX2 tumors was hyperechoic relative to liver parenchyma during the early phase and hypoechoic during the later phase. The curves obtained in carcinomas revealed an early arrival time and time to peak intensity with an irregular and sharp decrease of the intensity signal and a very early return to baseline, presenting a much more rapid wash-in and wash-out of ultrasonographic contrast agents. There was a significant difference in the time to enhancement, time to peak intensity, peak signal intensity, and enhancement duration between the VX2 tumors and perineoplastic liver parenchyma (P < .001). CONCLUSIONS: Single-level dynamic contrast-enhanced ultrasonography with a low mechanical index level could provide real-time and continuous enhanced images and fully delineate the typical enhancement pattern of liver tumors. The analysis of time-intensity curves may provide useful, complementary, and quantitative information. This technique may be useful for the diagnosis of liver tumors, especially those showing an atypical enhancement pattern on biphasic helical computed tomographic scanning.

Animals↗

[Relationship between early enhanced helical CT and tumor angiogenesis in bladder cancer].

OBJECTIVE: To study the relationship between enhanced degree in the cancer lesion and angiogenesis in the tumor through early manifestations in enhanced helical CT in patients with bladder cancer. METHODS: Fifty-three patients with bladder carcinoma were examined by pelvic plain CT and helical CT scan at peak enhancement of cancer lesion. Histologic grade, vascular endothelial growth factor (VEGF) and micro-vascular density (MVD) were analyzed for each resected cancer lesion. Pearson and Spearman correlation tests were used to assess the relationship between CT enhancement and histologic grade, VEGF or MVD. RESULTS: In early enhancing phase of helical CT, different degrees of enhancement were observed in 73 bladder cancer lesions. The difference between average CT attenuation and MVD in different histologic grade cancer lesions was statistically significant (P < 0.001). A positive correlation was found between the CT enhancement and MVD (gamma = 0.936, P < 0.001), histologic grade (gamma = 0.75, P < 0.001), but VEGF of bladder cancer did not correlate with the CT enhancement or MVD. CONCLUSION: The early enhancement of helical CT enhancement of bladder cancer, showing a positive relation to MVD and histologic grade, can reflect the tumor angiogenesis and blood supply.

Adult↗

Differential diagnosis of hepatic neoplasms: spin echo versus gadolinium-diethylenetriaminepentaacetate-enhanced gradient echo imaging.

Early results are reported of hepatic neoplasms studied with dynamic gadolinium-diethylenetriaminepentaacetate (Gd-DTPA)-enhanced magnetic resonance imaging (MRI). The purpose of this study was to evaluate the potential of the Gd enhancement pattern for characterizing these neoplasms and to compare the performance of spin-echo (SE) to SE plus dynamic Gd-enhanced gradient-echo (GRE) pulse sequences. Forty-two patients with hepatic neoplasms were examined at 1.5 T field strength. In each patient, short and long repetition time/echo time (TR/TE) SE images were obtained, followed by pre- and post-Gd-DTPA (0.1 mmol/kg body wt), single-slice, breath-hold (13 s/scan) GRE images, which were serially acquired less than or equal to 12 min postinjection. The patterns of contrast enhancement of the various hepatic lesions were documented and analyzed. The time to peak Gd signal enhancement-to-noise ratio (SE/N), contrast-to-noise ratio (C/N), contrast (defined as the signal intensity ratio [SIR]), as well as the peak values of these quantities, were determined. The C/N and SIR values on the short and long TR/TE SE and pre-Gd GRE images for all hepatic neoplasms were also obtained. The discriminating abilities (hemangiomas vs. malignant neoplasms) of these quantities were analyzed statistically. In addition, the impact of lesion characterization on the SE versus the SE plus the Gd-enhanced GRE scans was assessed by means of a blinded reader study. Malignant hepatic neoplasms could be differentiated from hemangiomas by visual inspection of their enhancement patterns (p = 0.0009), by the time to peak C/N on Gd-enhanced images (p = 0.0002), and by the magnitude of such peak (p = 0.02). Combined SE + Gd-enhanced GRE scans afforded minor, though statistically significant (p less than 0.01), improvement of the accuracy in differentiating benign from malignant hepatic neoplasms. Late scans (12 min post-Gd) may be particularly useful in identifying hemangiomas that, unlike other neoplasms, have a significant high signal of their enhancing portions on such images.

Adult↗

Cerebral ischemia: evaluation with contrast-enhanced MR imaging.

Eighty patients with a total of 82 ischemic lesions were examined with contrast-enhanced MR imaging 1 hr to 1 month after onset of symptoms. The studies were reviewed retrospectively to determine the presence of arterial enhancement and the patterns of parenchymal enhancement. Arterial enhancement was often detected on the initial MR examination (45%), was frequently demonstrated in cortical infarction (86%), in some cases preceded the development of signal changes on T2-weighted images, and resolved by 11 days. The presence of arterial enhancement appeared to be a better indicator of clinical severity than was the presence of proximal vessel occlusion on MR or angiographic studies. Two patterns of parenchymal enhancement were seen: progressive enhancement and early and/or intense enhancement. In patients with the progressive pattern, parenchymal enhancement on postcontrast T1-weighted images was rarely seen before 7 days, while signal abnormalities on T2-weighted images were intense during the first few days. The early and/or intense enhancement pattern was usually present within the first 3 days, approximated or exceeded the area and intensity of signal changes on T2-weighted images, and was usually associated with minimal or reversible neurologic sequelae (except when located in or near a watershed zone), suggesting a lesser degree of ischemic insult than was associated with the progressive pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

An enhancer element in the far upstream spacer region of rat ribosomal RNA gene.

To determine whether far upstream 5'-flanking sequences control rat rDNA transcription, we constructed plasmids containing several 5' and 3' deletions within the nontranscribed spacer region. In vitro transcription of these plasmids identified three enhancer regions, designated A, B, and C, which can dramatically stimulate transcription from the core promoter. Further analysis of region B showed that the enhancer element lies between -2.183 and -2.357 kilobase pairs upstream of the initiation site. The plasmid containing the 174-base pair enhancer element could stimulate rRNA gene transcription as much as 10-20-fold relative to transcription of the plasmid containing only the core promoter. This enhancer was not another promoter domain and could function irrespective of its orientation or distance from the promoter or when inserted downstream of the initiation site. Computer analysis of known sequences of enhancer regions A and C did not reveal any significant homology between these DNA segments and the 174-base pair enhancer element. Competition assay demonstrated that the enhancer element B forms a stable complex with the transcription factor(s) and that interaction between the enhancer and the factor(s) was essential for the stimulation of rDNA transcription. This is the first report of a mammalian ribosomal rDNA enhancer element that exhibits the characteristics of an RNA polymerase II enhancer.

Animals↗

[Value of contrast-enhanced CT scan in prediction of development of contusional hemorrhage].

It is often experienced that even if there are no significant findings on the initial plain CT scan in the patient with cerebral contusion, the patient has thereafter a serious clinical course and requires emergency operation for so-called contusional hemorrhage. In order to predict of the development of contusional hemorrhage we performed contrast-enhanced CT scan at the time of patient's arrival within 12 hours after injury, if there was cerebral contusion on 24 hours after the contrast-enhanced CT scan. If enhancement was demonstrated on the contrast-enhanced CT scan, we predicted the development of contusional hemorrhage and if not demonstrated, we predicted no more development of contusional hemorrhage and then we studied the correlation between the prediction and the plain CT 24 hours after the contrast-enhanced CT scan. The results were as follows: 1) The prediction was correct in 13 cases out of 16 cases in which the development of contusional hemorrhage was observed. In 18 cases where no development of contusional hemorrhage was observed, the prediction was correct without exception. 2) Most of the cases in which enhancement was demonstrated were ones examined not before 3 hours after injury. 3) The extent of enhancement shown on contrast-enhanced CT scan was well consistent with that of contusional hemorrhage on the plain CT scan 24 hours after the contrast-enhanced CT scan. From these results, the contrast-enhanced CT scan in acute stage of head injury was considered to by very useful in prediction of the development of contusional hemorrhage.

Adolescent↗